Provider Demographics
NPI:1780794354
Name:IQBAL, MOHAMMED ANWARUDDIN (PHD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:ANWARUDDIN
Last Name:IQBAL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:243 BRITTANY LN
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4324
Mailing Address - Country:US
Mailing Address - Phone:585-275-1077
Mailing Address - Fax:585-273-3360
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX 608
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-1077
Practice Address - Fax:585-273-3360
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYIQBAM1282N00000X, 291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered282N00000XHospitalsGeneral Acute Care Hospital
Not Answered291U00000XLaboratoriesClinical Medical Laboratory